1 473 150 CHARACTERISTICS OF YOGA USERS: RESULTS OF A NATIONAL SURVEY. BACKGROUND: THERE ARE LIMITED DATA ON THE CHARACTERISTICS OF YOGA USERS IN THE U.S. OBJECTIVE: TO CHARACTERIZE YOGA USERS, MEDICAL REASONS FOR USE, PERCEPTIONS OF HELPFULNESS, AND DISCLOSURE OF USE TO MEDICAL PROFESSIONALS. METHODS: UTILIZING CROSS-SECTIONAL SURVEY DATA FROM THE 2002 NATIONAL HEALTH INTERVIEW SURVEY (NHIS) ALTERNATIVE MEDICINE SUPPLEMENT (N = 31044), WE EXAMINED CORRELATES OF YOGA USE FOR HEALTH. THE ESTIMATED PREVALENCE FROM 2002 NHIS OF YOGA FOR HEALTH WAS 5.1% CORRESPONDING TO OVER 10 MILLION ADULTS. RESULTS: IN 2002, YOGA USERS WERE PREDOMINATELY CAUCASIAN (85%) AND FEMALE (76%) WITH A MEAN AGE OF 39.5 YEARS. COMPARED TO NON-YOGA USERS, YOGA USERS WERE MORE LIKELY FEMALE (OR 3.76, 95% CI 3.11-4.33); LESS LIKELY BLACK THAN WHITE (OR 0.65, 95% CI 0.53-0.80); TENDED TO BE YOUNGER; AND MORE LIKELY COLLEGE EDUCATED (OR 2.70, 95% CI 2.37-3.08). MUSCULOSKELETAL CONDITIONS (OR 1.61, 95% CI 1.42-1.83), MENTAL HEALTH CONDITIONS (OR 1.43, 95% CI 1.22-1.67), SEVERE SPRAINS IN THE LAST 12 MONTHS (OR 1.49, 95% CI 1.22-1.81), AND ASTHMA (OR 1.27, 95% CI 1.05-1.54) WERE INDEPENDENTLY ASSOCIATED WITH HIGHER YOGA USE, WHILE HYPERTENSION (OR 0.78, 95% CI 0.64-0.95) AND CHRONIC OBSTRUCTIVE LUNG DISEASE (OR 0.69, 95% CI 0.48-1.00) WERE ASSOCIATED WITH LOWER USE. YOGA WAS MOST COMMONLY USED TO TREAT MUSCULOSKELETAL OR MENTAL HEALTH CONDITIONS, AND MOST USERS REPORTED YOGA TO BE HELPFUL FOR THESE CONDITIONS. A MAJORITY OF YOGA USERS (61%) FELT YOGA WAS IMPORTANT IN MAINTAINING HEALTH, THOUGH ONLY 25% DISCLOSED YOGA PRACTICE TO THEIR MEDICAL PROFESSIONAL. CONCLUSIONS: WE FOUND THAT YOGA USERS ARE MORE LIKELY TO BE WHITE, FEMALE, YOUNG AND COLLEGE EDUCATED. YOGA USERS REPORT BENEFIT FOR MUSCULOSKELETAL CONDITIONS AND MENTAL HEALTH, INDICATING THAT FURTHER RESEARCH ON THE EFFICACY OF YOGA FOR THE TREATMENT AND/OR PREVENTION OF THESE CONDITIONS IS WARRANTED. 2008 2 1801 53 PREVALENCE AND PATTERNS OF ADULT YOGA USE IN THE UNITED STATES: RESULTS OF A NATIONAL SURVEY. BACKGROUND: ALTHOUGH YOGA APPEARS TO BE POPULAR IN THE UNITED STATES, THERE ARE NO PUBLISHED STUDIES ON YOGA'S PREVALENCE OR PATTERNS OF USE. METHODS: IN 1998 WE SURVEYED BY TELEPHONE A NATIONALLY REPRESENTATIVE SAMPLE OF 2055 ENGLISH-SPEAKING U.S. ADULTS (60% WEIGHTED RESPONSE RATE) REGARDING YOGA USE. RESULTS: OF THE RESPONDENTS, 7.5% USED YOGA AT LEAST ONCE IN THEIR LIFETIME AND 3.8% USED YOGA IN THE PREVIOUS 12 MONTHS. RESPONDENTS WHO USED YOGA AT LEAST ONCE WERE MORE LIKELY THAN NON-USERS TO BE FEMALE (68% VS. 51%), COLLEGE EDUCATED (68% VS. 45%), AND URBAN DWELLERS (93% VS. 74%). FACTORS INDEPENDENTLY ASSOCIATED WITH YOGA USE AT LEAST ONCE INCLUDED FEMALE GENDER (OR 2.5 [95% CI 1.7-3.8]), BABY BOOMER AGE GROUP (AGES 34-53) COMPARED TO PRE-BABY BOOMERS (> OR = 54 (2.3 [1.4-4.0]), EDUCATION BEYOND HIGH SCHOOL (2.2 [1.4-3.5]), RESIDING IN LARGE AND SMALL METROPOLITAN AREAS COMPARED TO NON-METROPOLITAN AREAS (3.8 [1.8-7.8] AND 2.7 [1.3-5.8], RESPECTIVELY), AND USE OF OTHER CAM THERAPIES (5.3 [2.7-10.5]). OF RESPONDENTS USING YOGA IN THE PREVIOUS 12 MONTHS, 64% REPORTED USING YOGA FOR WELLNESS, 48% FOR HEALTH CONDITIONS, AND 21% SPECIFICALLY FOR BACK OR NECK PAIN. NINETY PERCENT FELT YOGA WAS VERY OR SOMEWHAT HELPFUL AND 76% DID NOT REPORT SPENDING MONEY RELATED TO THEIR YOGA. CONCLUSIONS: IN 1998 AN ESTIMATED 15.0 MILLION AMERICAN ADULTS HAD USED YOGA AT LEAST ONCE IN THEIR LIFETIME AND 7.4 MILLION DURING THE PREVIOUS YEAR. YOGA WAS USED FOR BOTH WELLNESS AND SPECIFIC HEALTH CONDITIONS OFTEN WITH PERCEIVED HELPFULNESS AND WITHOUT EXPENDITURE. 2004 3 592 29 DEVELOPMENT AND EVALUATION OF A YOGA EXERCISE PROGRAMME FOR OLDER ADULTS. AIM: THIS STUDY REPORTS THE DEVELOPMENT AND EVALUATION OF A NEW YOGA EXERCISE PROGRAMME FOR OLDER ADULTS, CALLED THE SILVER YOGA PROGRAMME. BACKGROUND: YOGA PRACTICE IS ASSOCIATED WITH NUMEROUS HEALTH IMPROVEMENTS, INCLUDING REDUCED CARDIOVASCULAR RISK, BODY MASS INDEX AND BLOOD PRESSURE. YOGA IS ALSO ASSOCIATED WITH IMPROVED RESPIRATION, PSYCHOLOGICAL HEALTH AND PAIN MANAGEMENT. STUDIES HAVE SUGGESTED THE BENEFICIAL EFFECTS OF YOGA IN THE OLDER POPULATION. METHOD: THE STUDY WAS CONDUCTED IN 2005 AND IT HAD TWO PHASES. PHASE I CONSISTED OF SENDING A SURVEY TO 10 EXPERTS TO HELP DEVELOP THE SILVER YOGA PROGRAMME. A HARD COPY AND A VIDEO CONTAINING DETAILED DESCRIPTIONS AND DEMONSTRATIONS OF THE PROGRAMME WERE THEN SENT TO THE EXPERTS FOR REVIEW AND CRITIQUE REGARDING THE CLARITY AND FEASIBILITY OF THE YOGA POSTURES. PHASE II WAS AN ENQUIRY INTO OLDER ADULTS' VIEWS ON THE PROGRAMME USING A QUANTITATIVE EVALUATION AND SEMI-STRUCTURED QUALITATIVE INQUIRY. FOURTEEN WOMEN PARTICIPANTS FROM A SENIOR ACTIVITY CENTRE WERE INTERVIEWED INDIVIDUALLY AFTER 1 MONTH OF SILVER YOGA GROUP PRACTICE, THREE TIMES PER WEEK, 70 MINUTES PER SESSION. THEY WERE ASKED TO EVALUATE THE APPROPRIATENESS OF POSTURES BASED ON THE CRITERIA OF DIFFICULTY, ACCEPTABILITY, FEASIBILITY AND HELPFULNESS. FIVE OPEN-ENDED QUESTIONS ASKED PARTICIPANTS TO REFLECT ON THEIR YOGA EXPERIENCES. RESULTS: PARTICIPANTS' MEAN RATINGS OF THE ACCEPTABILITY, FEASIBILITY AND HELPFULNESS OF THE FOUR ASPECTS OF THE PROGRAMME (WARM-UP, HATHA YOGA, RELAXATION AND GUIDED-IMAGERY MEDITATION) RANGED FROM 8.8 +/- 1.9 TO 9.3 +/- 1.5; MEAN RATINGS OF THE DIFFICULTY OF THE PROGRAMME REVEALED THAT RELAXATION AND GUIDED-IMAGERY MEDITATION WERE FAIRLY EASY TO FOLLOW (0.1 +/- 0.3 AND 0.1 +/- 0.3 RESPECTIVELY), BUT THE POSTURES IN THE HATHA YOGA WERE RELATIVELY CHALLENGING (2.1 +/- 2.6). CONCLUSION: THE SILVER YOGA PROGRAMME SHOULD UNDERGO FURTHER PILOT-TESTING WITH LARGER SAMPLES OF OLDER ADULTS BEFORE IT IS TAKEN UP INTERNATIONALLY AS A HEALTH-PROMOTION ACTIVITY FOR OLDER ADULTS. 2007 4 502 31 COMMUNITY VS. INSTITUTIONAL ELDERS' EVALUATIONS OF AND PREFERENCES FOR YOGA EXERCISES. AIMS: TO EVALUATE AND COMPARE THE APPROPRIATENESS OF THE SILVER YOGA EXERCISE PROGRAMME FOR COMMUNITY AND INSTITUTIONAL ELDERS AND TO DETERMINE THEIR PREFERENCES TOWARDS YOGA EXERCISES. BACKGROUND: YOGA HAS BEEN USED TO PROMOTE THE HEALTH OF ELDERS. THE SILVER YOGA WAS DEVELOPED TO ACCOMMODATE THE PHYSICAL TOLERANCE AND BODY FLEXIBILITY OF ELDERS AND APPLIED TO COMMUNITY AND INSTITUTIONAL ELDERS WITH POSITIVE HEALTH PROMOTION BENEFITS. DESIGN: DESCRIPTIVE DESIGN WITH QUANTITATIVE PROGRAMME EVALUATION AND SEMI-STRUCTURED INTERVIEWS. METHOD: A CONVENIENCE SAMPLE OF 97 PARTICIPANTS (64 COMMUNITY ELDERS; 33 INSTITUTIONAL ELDERS) WAS INTERVIEWED INDIVIDUALLY AFTER SIX MONTHS OF SILVER YOGA EXERCISES. PARTICIPANTS RATED THE LEVEL OF DIFFICULTY, ACCEPTABILITY, FEASIBILITY AND HELPFULNESS OF THE SILVER YOGA PROGRAMME (FOUR PHASES: WARM-UP, HATHA YOGA, RELAXATION AND GUIDED-IMAGERY MEDITATION) AND THE ABDOMINAL BREATHING TECHNIQUE, BASED ON A 10-POINT CANTRIL LADDER SCALE. FURTHER, PARTICIPANTS EXPRESSED THEIR PREFERENCES OF YOGA EXERCISES BASED ON FOUR OPEN-ENDED QUESTIONS. RESULTS: THE PROGRAMME WAS FAIRLY ACCEPTABLE, FEASIBLE AND HELPFUL FOR COMMUNITY AND INSTITUTIONAL ELDERS (MEANS RANGED FROM 8.33-9.70). THE WARM-UP, RELAXATION, GUIDED-IMAGERY MEDITATION AND ABDOMINAL BREATHING ARE FAIRLY EASY TO FOLLOW AND PERFORM (MEANS RANGED FROM 0.20-0.94). HOWEVER, THE POSTURES IN HATHA YOGA PHASE WERE RELATIVELY CHALLENGING BUT STILL MANAGEABLE FOR THE INSTITUTIONAL ELDERS (MEAN = 1.97, SD 2.33). FURTHER, COMMUNITY ELDERS PREFERRED TO PRACTISE YOGA 61-90 MINUTES EVERYDAY IN A GROUP OF 11-20, WHILE THE INSTITUTIONAL ELDERS PREFERRED TO PRACTISE YOGA 31-60 MINUTES THREE TIMES PER WEEK, IN A GROUP OF <10. CONCLUSIONS: THE SILVER YOGA EXERCISE PROGRAMME IS ACCEPTABLE, FEASIBLE, HELPFUL AND MANAGEABLE FOR COMMUNITY AND INSTITUTIONAL ELDERS. HOWEVER, DIFFERENT EXERCISE PROTOCOLS, SUCH AS PRACTICE INTENSITY AND GROUP SIZE, COULD BE APPLIED TO DIFFERENT OLDER POPULATIONS. RELEVANCE TO CLINICAL PRACTICE: THE SILVER YOGA EXERCISE PROGRAMME COULD BE APPLIED TO BOTH COMMUNITY AND INSTITUTIONAL ELDERS TO PROMOTE THEIR HEALTH. 2011 5 337 38 ARE INDIAN YOGA TRIALS MORE LIKELY TO BE POSITIVE THAN THOSE FROM OTHER COUNTRIES? A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS. OBJECTIVE: TO DETERMINE WHETHER THE CONCLUSIONS OF RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA ARE MORE LIKELY TO BE POSITIVE WHEN THEY WERE CONDUCTED IN INDIA AND/OR WHEN THEY ARE PUBLISHED IN COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) SPECIALTY JOURNALS. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, INDMED, AND THE TABLES OF CONTENT OF YOGA SPECIALTY JOURNALS NOT LISTED IN MEDICAL DATABASES WERE SCREENED THROUGH FEBRUARY 2014 FOR RCTS COMPARING YOGA INTERVENTIONS TO NON-YOGA INTERVENTIONS. THE RCTS' CONCLUSIONS WERE CLASSIFIED AS POSITIVE (YOGA IS HELPFUL FOR A RESPECTIVE CONDITION) OR NOT POSITIVE; AND COMPARED BETWEEN RCTS THAT WERE A) CONDUCTED IN INDIA VS. OUTSIDE INDIA, AND B) PUBLISHED IN A CAM SPECIALTY JOURNAL OR ANOTHER TYPE OF JOURNAL. RESULTS: A TOTAL OF 306 RCTS WERE INCLUDED; 131 FROM INDIA AND 175 FROM OTHER COUNTRIES; AND 84 FROM CAM SPECIALTY JOURNALS AND 222 FROM OTHER TYPES OF JOURNALS. POSITIVE CONCLUSIONS WERE REACHED IN 277 RCTS (91%); WITH MORE POSITIVE RCTS BEING CONDUCTED IN INDIA THAN ELSEWHERE (ODDS RATIO=24.8; 95% CONFIDENCE INTERVAL=3.3, 184.5; P<0.001) WHILE TYPE OF JOURNAL WAS NOT ASSOCIATED WITH THE DIRECTION OF THE CONCLUSIONS (ODDS RATIO=1.2; 95% CONFIDENCE INTERVAL=0.5, 2.9; P=0.828). CONCLUSIONS: RCTS ON YOGA THAT ARE CONDUCTED IN INDIA HAVE ABOUT 25 TIMES THE ODDS OF REACHING POSITIVE CONCLUSIONS AS THOSE CONDUCTED ELSEWHERE. INDIAN TRIALS SHOULD BE DEALT WITH CAREFULLY WHEN EVALUATING THE HELPFULNESS OF YOGA FOR PATIENTS IN OTHER COUNTRIES AND VICE VERSA. 2015 6 291 48 ADVERSE EFFECTS OF YOGA: A NATIONAL CROSS-SECTIONAL SURVEY. BACKGROUND: WHILE YOGA IS INCREASINGLY USED FOR HEALTH PURPOSES, ITS SAFETY HAS BEEN QUESTIONED. THE AIM OF THIS CROSS-SECTIONAL SURVEY WAS TO ANALYZE YOGA-ASSOCIATED ADVERSE EFFECTS AND THEIR CORRELATES. METHODS: A CROSS-SECTIONAL ANONYMOUS NATIONAL ONLINE SURVEY AMONG GERMAN YOGA PRACTITIONERS (N = 1702; 88.9% FEMALE; 47.2 +/- 10.8 YEARS) WAS CONDUCTED FROM JANUARY TO JUNE 2016. PARTICIPANTS WERE QUERIED REGARDING THEIR YOGA PRACTICE, I.E. YOGA STYLES USED, LENGTH AND INTENSITY OF YOGA PRACTICE, PRACTICE PATTERNS, AND WHETHER THEY HAD EXPERIENCED ACUTE OR CHRONIC ADVERSE EFFECTS OF THEIR YOGA PRACTICE. INDEPENDENT PREDICTORS OF ACUTE OR CHRONIC ADVERSE EFFECTS WERE IDENTIFIED USING MULTIPLE LOGISTIC REGRESSION ANALYSES. RESULTS: ASHTANGA YOGA (15.7%), TRADITIONAL HATHA YOGA (14.2%), AND SIVANANDA YOGA (22.4%) WERE THE MOST COMMONLY USED YOGA STYLES. 364 (21.4%) YOGA USERS REPORTED 702 ACUTE ADVERSE EFFECTS, OCCURRING AFTER A MEAN OF 7.6 +/- 8.0 YEARS OF YOGA PRACTICE. THE MOST COMMONLY REPORTED YOGA PRACTICES THAT WERE ASSOCIATED WITH ACUTE ADVERSE EFFECTS WERE HAND-, SHOULDER- AND HEAD STANDS (29.4%). USING VINIYOGA WAS ASSOCIATED WITH A DECREASED RISK OF ACUTE ADVERSE EFFECTS; PRACTICING ONLY BY SELF-STUDY WITHOUT SUPERVISION WAS ASSOCIATED WITH HIGHER RISK. ONE HUNDRED SEVENTY-THREE PARTICIPANTS (10.2%) REPORTED 239 CHRONIC ADVERSE EFFECTS. THE RISK OF CHRONIC ADVERSE EFFECTS WAS HIGHER IN PARTICIPANTS WITH CHRONIC ILLNESSES AND THOSE PRACTICING ONLY BY SELF-STUDY WITHOUT SUPERVISION. MOST REPORTED ADVERSE EFFECTS CONCERNED THE MUSCULOSKELETAL SYSTEM. 76.9% OF ACUTE CASES, AND 51.6% OF CHRONIC CASES REACHED FULL RECOVERY. ON AVERAGE 0.60 INJURIES (95% CONFIDENCE INTERVAL = 0.51-0.71) PER 1000 H OF PRACTICE WERE REPORTED, WITH POWER YOGA USERS REPORTING THE HIGHEST RATE (1.50 INJURIES PER 1000 H; 95% CONFIDENCE INTERVAL = 0.98-3.15). CONCLUSIONS: ONE IN FIVE ADULT YOGA USERS REPORTED AT LEAST ONE ACUTE ADVERSE EFFECT IN THEIR YOGA PRACTICE, AND ONE IN TEN REPORTED AT LEAST ONE CHRONIC ADVERSE EFFECT, MAINLY MUSCULOSKELETAL EFFECTS. ADVERSE EFFECTS WERE ASSOCIATED WITH HAND-, SHOULDER- AND HEAD STANDS; AND WITH YOGA SELF-STUDY WITHOUT SUPERVISION. MORE THAN THREE QUARTERS OF OF CASES REACHED FULL RECOVERY. BASED ON THE OVERALL INJURY RATE PER 1000 PRACTICE HOURS, YOGA APPEARS TO BE AS SAFE OR SAFER WHEN COMPARED TO OTHER EXERCISE TYPES. 2019 7 1509 31 IS ONE YOGA STYLE BETTER THAN ANOTHER? A SYSTEMATIC REVIEW OF ASSOCIATIONS OF YOGA STYLE AND CONCLUSIONS IN RANDOMIZED YOGA TRIALS. OBJECTIVE: TO DETERMINE WHETHER THE ODDS OF POSITIVE CONCLUSIONS IN RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA, DIFFER BETWEEN YOGA STYLES. DESIGN: SYSTEMATIC REVIEW OF YOGA RCTS. MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, INDMED AND THE TABLES OF CONTENT OF SPECIALIST YOGA JOURNALS, NOT LISTED IN MEDICAL DATABASES, WERE SCREENED UP TO 12 FEBRUARY, 2014 FOR RCTS COMPARING YOGA INTERVENTIONS TO NON-YOGA INTERVENTIONS. THE RCTS' CONCLUSIONS WERE CLASSIFIED AS POSITIVE (YOGA IS HELPFUL FOR A RESPECTIVE CONDITION) OR NOT POSITIVE; AND THESE WERE COMPARED BETWEEN DIFFERENT YOGA STYLES USING THE CHI SQUARED TEST AND MULTIPLE LOGISTIC REGRESSION ANALYSIS. RESULTS: A TOTAL OF 306 RCTS WERE INCLUDED. THESE APPLIED 52 DIFFERENT YOGA STYLES, THE MOST COMMONLY USED OF WHICH WERE: HATHA YOGA (36 RCTS), IYENGAR YOGA (31 RCTS), PRANAYAMA (26 RCTS), AND THE INTEGRATED APPROACH TO YOGA THERAPY (15 RCTS). POSITIVE CONCLUSIONS WERE REACHED IN 277 RCTS (91%); THE PROPORTION OF POSITIVE CONCLUSIONS DID NOT DIFFER BETWEEN YOGA STYLES (P=0.191). CONCLUSION: RCTS WITH DIFFERENT YOGA STYLES DO NOT DIFFER IN THEIR ODDS OF REACHING POSITIVE CONCLUSIONS. GIVEN THAT MOST RCTS WERE POSITIVE, THE CHOICE OF AN INDIVIDUAL YOGA STYLE CAN BE BASED ON PERSONAL PREFERENCES AND AVAILABILITY. 2016 8 518 36 COMPARING ONCE- VERSUS TWICE-WEEKLY YOGA CLASSES FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY LOW INCOME MINORITIES: A RANDOMIZED DOSING TRIAL. BACKGROUND. PREVIOUS STUDIES HAVE DEMONSTRATED THAT ONCE-WEEKLY YOGA CLASSES ARE EFFECTIVE FOR CHRONIC LOW BACK PAIN (CLBP) IN WHITE ADULTS WITH HIGH SOCIOECONOMIC STATUS. THE COMPARATIVE EFFECTIVENESS OF TWICE-WEEKLY CLASSES AND GENERALIZABILITY TO RACIALLY DIVERSE LOW INCOME POPULATIONS ARE UNKNOWN. METHODS. WE CONDUCTED A 12-WEEK RANDOMIZED, PARALLEL-GROUP, DOSING TRIAL FOR 95 ADULTS RECRUITED FROM AN URBAN SAFETY-NET HOSPITAL AND FIVE COMMUNITY HEALTH CENTERS COMPARING ONCE-WEEKLY (N = 49) VERSUS TWICE-WEEKLY (N = 46) STANDARDIZED YOGA CLASSES SUPPLEMENTED BY HOME PRACTICE. PRIMARY OUTCOMES WERE CHANGE FROM BASELINE TO 12 WEEKS IN PAIN (11-POINT SCALE) AND BACK-RELATED FUNCTION (23-POINT MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE). RESULTS. 82% OF PARTICIPANTS WERE NONWHITE; 77% HAD ANNUAL HOUSEHOLD INCOMES <$40,000. THE SAMPLE'S BASELINE MEAN PAIN INTENSITY [6.9 (SD 1.6)] AND FUNCTION [13.7 (SD 5.0)] REFLECTED MODERATE TO SEVERE BACK PAIN AND IMPAIRMENT. PAIN AND BACK-RELATED FUNCTION IMPROVED WITHIN BOTH GROUPS (P < 0.001). HOWEVER, THERE WERE NO DIFFERENCES BETWEEN ONCE-WEEKLY AND TWICE-WEEKLY GROUPS FOR PAIN REDUCTION [-2.1 (95% CI -2.9, -1.3) VERSUS -2.4 (95% CI -3.1, -1.8), P = 0.62] OR BACK-RELATED FUNCTION [-5.1 (95% CI -7.0, -3.2) VERSUS -4.9 (95% CI -6.5, -3.3), P = 0.83]. CONCLUSIONS. TWELVE WEEKS OF ONCE-WEEKLY OR TWICE-WEEKLY YOGA CLASSES WERE SIMILARLY EFFECTIVE FOR PREDOMINANTLY LOW INCOME MINORITY ADULTS WITH MODERATE TO SEVERE CHRONIC LOW BACK PAIN. THIS TRIAL IS REGISTERED WITH CLINICALTRIALS.GOV NCT01761617. 2013 9 1445 51 INCREASING TREND OF YOGA PRACTICE AMONG U.S. ADULTS FROM 2002 TO 2017. INTRODUCTION: BENEFITS, RISKS, AND THE INCREASING POPULARITY OF YOGA USE WARRANT ASSESSING YOGA PRACTICE PREVALENCE AND USERS' PROFILES. THIS STUDY DESCRIBES TRENDS IN YOGA PRACTICE EXCLUSIVELY AMONG AMERICAN ADULTS FROM 2002 TO 2017, COMPARES THE PROFILE OF YOGA USERS, AND IDENTIFIES FACTORS RELATED TO YOGA USE OVER TIME. MATERIALS AND METHODS: THIS STUDY IS A SECONDARY ANALYSIS DONE IN 2019 AND 2020 USING THE NATIONAL HEALTH INTERVIEW SURVEY (NHIS) 2002, 2007, 2012, AND 2017 DATA. POPULATION WEIGHTS WERE USED TO OBTAIN STATISTICALLY ACCURATE ESTIMATES OF YOGA USE PREVALENCE FOR THE U.S. POPULATION. DESCRIPTIVE STATISTICS WERE USED TO PROFILE THE SOCIODEMOGRAPHIC AND HEALTH-RELATED CHARACTERISTICS OF YOGA USERS. MULTIVARIABLE LOGISTIC REGRESSION WAS USED TO IDENTIFY FACTORS ASSOCIATED WITH YOGA USE IN EACH COHORT DEFINED BY THE NHIS YEAR. RESULTS: YOGA PRACTICE PREVALENCE NEARLY TRIPLED FROM 5.1% IN 2002 TO 13.7% IN 2017 (WEIGHTED ESTIMATE 10,386,456 AND 32,761,194 AMERICAN ADULTS, RESPECTIVELY). TYPICAL YOGA USERS WERE YOUNG NON-HISPANIC SINGLE WHITE FEMALE ADULTS WITH BACHELOR OR HIGHER EDUCATION AND HEALTH INSURANCE, AND RESIDED IN THE WEST REGION OF THE UNITED STATES. YOGA USE PATTERN CHANGE OVER TIME WAS SIGNIFICANTLY RELATED TO ONLY YOUNGER AGE (P < 0.001) BUT NOT TO OTHER SOCIODEMOGRAPHIC OR HEALTH-RELATED FACTORS. CONCLUSIONS: YOGA HAS GAINED INCREASING POPULARITY IN THE PAST TWO DECADES AMONG AMERICAN ADULTS, WITH YOUNGER ADULTS BEING THE DRIVING FORCE. YOGA APPEARS TO BE ADOPTED FOR GENERAL WELL-BEING OR PREVENTION MORE THAN FOR SPECIFIC DISEASE TREATMENT. FUTURE RESEARCH SHOULD EVALUATE HOW YOGA CAN BE EFFECTIVELY AND SAFELY INTEGRATED INTO PREVENTIVE MEDICINE STRATEGIES. 2021 10 1742 28 PHYSICAL FITNESS OF OLDER ADULTS IN SENIOR ACTIVITY CENTRES AFTER 24-WEEK SILVER YOGA EXERCISES. AIMS AND OBJECTIVES: PROMOTING PHYSICAL FITNESS OF YOUNG-OLDER ADULTS IS ESSENTIAL IN REDUCING HEALTHCARE EXPENDITURES WHICH WOULD OCCUR IN THE FUTURE FOR THOSE WITH CHRONIC HEALTH PROBLEMS. THE SILVER YOGA EXERCISE PROGRAMME WAS DEVELOPED TO ACCOMMODATE THE REDUCED BODY FLEXIBILITY EXPERIENCED BY MANY OLDER ADULTS AND WAS CRITICALLY REVIEWED BY EXPERTS AND PILOT-TESTED WITH COMMUNITY-DWELLING OLDER ADULTS. THIS STUDY AIMED TO TEST OLDER ADULTS' PHYSICAL FITNESS AFTER A 24-WEEK SILVER YOGA EXERCISE PROGRAMME AND TO EXAMINE WHETHER THE PROGRAMME COULD BE FURTHER SHORTENED TO FIT SENIOR ACTIVITY CENTRES' PROGRAMME DESIGNS. DESIGN: A QUASI-EXPERIMENTAL, PRE-POST TESTS DESIGN WAS USED: BASELINE, AT 12-WEEK AND AT 24-WEEK PERIODS. METHODS: CONVENIENCE SAMPLES OF 204 SUBJECTS WERE RECRUITED FROM EIGHT SENIOR ACTIVITY CENTRES AND 176 SUBJECTS COMPLETED THE STUDY. SUBJECTS WERE RANDOMLY ASSIGNED INTO THREE GROUPS BASED ON THE CENTRES: (1) EXPERIMENT I: COMPLETE SILVER YOGA WITH STRETCHING AND MEDITATION, (2) EXPERIMENT II: SHORTENED SILVER YOGA WITHOUT THE GUIDED-IMAGERY MEDITATION AND (3) WAIT-LIST CONTROL. THE INTERVENTIONS WERE CONDUCTED THREE TIMES PER WEEK FOR 24 WEEKS. PHYSICAL FITNESS INDICATORS INCLUDED BODY COMPOSITIONS, CARDIOVASCULAR-RESPIRATORY FUNCTIONS, PHYSICAL FUNCTIONS AND THE RANGE OF MOTION. RESULTS: AT THE END OF THE 24-WEEK PERIOD, THE PHYSICAL FITNESS OF SUBJECTS IN EXPERIMENTS I AND II HAD SIGNIFICANTLY IMPROVED WHETHER OR NOT GUIDED-IMAGERY MEDITATION WAS USED AND ALL HAD BETTER PHYSICAL FITNESS THAN SUBJECTS IN THE CONTROL GROUP (ALL P < 0.05). CONCLUSIONS: THE PHYSICAL FITNESS OF OLDER ADULTS IN BOTH THE 70-MINUTE COMPLETE SILVER YOGA GROUP AND THE 55-MINUTE SHORTENED SILVER YOGA GROUP HAD SIGNIFICANTLY IMPROVED AFTER THE INTERVENTIONS. IT WAS RECOMMENDED THAT THE SILVER YOGA PROGRAMME BE SHORTENED BY ELIMINATING THE GUIDED-IMAGERY MEDITATION. RELEVANCE TO CLINICAL PRACTICE: THE SHORTENED SILVER YOGA EXERCISE PROGRAMME IS RECOMMENDED TO BE INCORPORATED AS AN ACTIVITY PROGRAMME IN COMMUNITY-SETTINGS TO PROMOTE THE PHYSICAL FITNESS OF OLDER ADULTS. 2008 11 628 41 DIFFERENCES BETWEEN VEGETARIAN AND OMNIVOROUS YOGA PRACTITIONERS-RESULTS OF A NATIONALLY REPRESENTATIVE SURVEY OF US ADULT YOGA PRACTITIONERS. BACKGROUND: TO EXAMINE THE PREVALENCE OF VEGETARIANISM AMONG YOGA PRACTITIONERS, AND TO EXPLORE DIFFERENCES AND SIMILARITIES BETWEEN YOGA PRACTITIONERS WHO ALSO USE VEGETARIAN DIET AND THOSE WHO DO NOT. DESIGN AND SETTING: USING CROSS-SECTIONAL DATA FROM THE 2012 NATIONAL HEALTH INTERVIEW SURVEY (NHIS) (N = 34,525), WEIGHTED FREQUENCIES FOR 12-MONTH PREVALENCE OF VEGETARIAN DIET USE AMONG YOGA PRACTITIONERS WERE ANALYZED. LOGISTIC REGRESSION ANALYSES WERE USED TO ANALYZE SOCIODEMOGRAPHIC AND CLINICAL PREDICTORS OF VEGETARIAN DIET USE. RESULTS: A TOTAL OF 1.7 MILLION US YOGA PRACTITIONERS HAVE USED A VEGETARIAN DIET IN THE PAST 12 MONTHS (8.3%), COMPARED TO 2.7 MILLION NON-YOGA PRACTITIONERS (1.3%). YOGA PRACTITIONERS WHO WERE AGED BETWEEN 30 AND 64 YEARS AS COMPARED TO BEING 29 YEARS OR YOUNGER WERE MORE LIKELY TO HAVE USED A VEGETARIAN DIET IN THE PAST 12 MONTHS; WHILE THOSE BEING IN A RELATIONSHIP (OR = 0.64), OVERWEIGHT (OR = 0.54), SMOKING (OR 0.64) OR HAVING PRIVATE HEALTH INSURANCE (OR = 0.59) WERE LESS LIKELY. VEGETARIAN DIET PRACTITIONERS MORE OFTEN INCLUDED MEDITATION AS PART OF THEIR YOGA PRACTICE AND MORE OFTEN CHOSE YOGA BECAUSE IT HAD A HOLISTIC FOCUS, AND WAS PERCEIVED TO TREAT THE CAUSE AND NOT THE SYMPTOMS OF THEIR HEALTH COMPLAINT. CONCLUSIONS: YOGA PRACTITIONERS FOLLOWING A VEGETARIAN DIET SEEM TO EMBRACE YOGA MORE AS A LIFESTYLE THAN AS A THERAPY. 2018 12 2821 51 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. BACKGROUND: NON-SPECIFIC LOW BACK PAIN IS A COMMON, POTENTIALLY DISABLING CONDITION USUALLY TREATED WITH SELF-CARE AND NON-PRESCRIPTION MEDICATION. FOR CHRONIC LOW BACK PAIN, CURRENT GUIDELINES STATE THAT EXERCISE THERAPY MAY BE BENEFICIAL. YOGA IS A MIND-BODY EXERCISE SOMETIMES USED FOR NON-SPECIFIC LOW BACK PAIN. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING CHRONIC NON-SPECIFIC LOW BACK PAIN, COMPARED TO NO SPECIFIC TREATMENT, A MINIMAL INTERVENTION (E.G. EDUCATION), OR ANOTHER ACTIVE TREATMENT, WITH A FOCUS ON PAIN, FUNCTION, AND ADVERSE EVENTS. SEARCH METHODS: WE SEARCHED CENTRAL, MEDLINE, EMBASE, FIVE OTHER DATABASES AND FOUR TRIALS REGISTERS TO 11 MARCH 2016 WITHOUT RESTRICTION OF LANGUAGE OR PUBLICATION STATUS. WE SCREENED REFERENCE LISTS AND CONTACTED EXPERTS IN THE FIELD TO IDENTIFY ADDITIONAL STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMIZED CONTROLLED TRIALS OF YOGA TREATMENT IN PEOPLE WITH CHRONIC NON-SPECIFIC LOW BACK PAIN. WE INCLUDED STUDIES COMPARING YOGA TO ANY OTHER INTERVENTION OR TO NO INTERVENTION. WE ALSO INCLUDED STUDIES COMPARING YOGA AS AN ADJUNCT TO OTHER THERAPIES, VERSUS THOSE OTHER THERAPIES ALONE. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SCREENED AND SELECTED STUDIES, EXTRACTED OUTCOME DATA, AND ASSESSED RISK OF BIAS. WE CONTACTED STUDY AUTHORS TO OBTAIN MISSING OR UNCLEAR INFORMATION. WE EVALUATED THE OVERALL CERTAINTY OF EVIDENCE USING THE GRADE APPROACH. MAIN RESULTS: WE INCLUDED 12 TRIALS (1080 PARTICIPANTS) CARRIED OUT IN THE USA (SEVEN TRIALS), INDIA (THREE TRIALS), AND THE UK (TWO TRIALS). STUDIES WERE UNFUNDED (ONE TRIAL), FUNDED BY A YOGA INSTITUTION (ONE TRIAL), FUNDED BY NON-PROFIT OR GOVERNMENT SOURCES (SEVEN TRIALS), OR DID NOT REPORT ON FUNDING (THREE TRIALS). MOST TRIALS USED IYENGAR, HATHA, OR VINIYOGA FORMS OF YOGA. THE TRIALS COMPARED YOGA TO NO INTERVENTION OR A NON-EXERCISE INTERVENTION SUCH AS EDUCATION (SEVEN TRIALS), AN EXERCISE INTERVENTION (THREE TRIALS), OR BOTH EXERCISE AND NON-EXERCISE INTERVENTIONS (TWO TRIALS). ALL TRIALS WERE AT HIGH RISK OF PERFORMANCE AND DETECTION BIAS BECAUSE PARTICIPANTS AND PROVIDERS WERE NOT BLINDED TO TREATMENT ASSIGNMENT, AND OUTCOMES WERE SELF-ASSESSED. THEREFORE, WE DOWNGRADED ALL OUTCOMES TO 'MODERATE' CERTAINTY EVIDENCE BECAUSE OF RISK OF BIAS, AND WHEN THERE WAS ADDITIONAL SERIOUS RISK OF BIAS, UNEXPLAINED HETEROGENEITY BETWEEN STUDIES, OR THE ANALYSES WERE IMPRECISE, WE DOWNGRADED THE CERTAINTY OF THE EVIDENCE FURTHER.FOR YOGA COMPARED TO NON-EXERCISE CONTROLS (9 TRIALS; 810 PARTICIPANTS), THERE WAS LOW-CERTAINTY EVIDENCE THAT YOGA PRODUCED SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE TO FOUR MONTHS (STANDARDIZED MEAN DIFFERENCE (SMD) -0.40, 95% CONFIDENCE INTERVAL (CI) -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) -2.18, 95% -3.60 TO -0.76), MODERATE-CERTAINTY EVIDENCE FOR SMALL TO MODERATE IMPROVEMENTS AT SIX MONTHS (SMD -0.44, 95% CI -0.66 TO -0.22; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -2.15, 95% -3.23 TO -1.08), AND LOW-CERTAINTY EVIDENCE FOR SMALL IMPROVEMENTS AT 12 MONTHS (SMD -0.26, 95% CI -0.46 TO -0.05; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -1.36, 95% -2.41 TO -0.26). ON A 0-100 SCALE THERE WAS VERY LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA WAS SLIGHTLY BETTER FOR PAIN AT THREE TO FOUR MONTHS (MD -4.55, 95% CI -7.04 TO -2.06), SIX MONTHS (MD -7.81, 95% CI -13.37 TO -2.25), AND 12 MONTHS (MD -5.40, 95% CI -14.50 TO -3.70), HOWEVER WE PRE-DEFINED CLINICALLY SIGNIFICANT CHANGES IN PAIN AS 15 POINTS OR GREATER AND THIS THRESHOLD WAS NOT MET. BASED ON INFORMATION FROM SIX TRIALS, THERE WAS MODERATE-CERTAINTY EVIDENCE THAT THE RISK OF ADVERSE EVENTS, PRIMARILY INCREASED BACK PAIN, WAS HIGHER IN YOGA THAN IN NON-EXERCISE CONTROLS (RISK DIFFERENCE (RD) 5%, 95% CI 2% TO 8%).FOR YOGA COMPARED TO NON-YOGA EXERCISE CONTROLS (4 TRIALS; 394 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE IN BACK-RELATED FUNCTION AT THREE MONTHS (SMD -0.22, 95% CI -0.65 TO 0.20; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.99, 95% -2.87 TO 0.90) AND SIX MONTHS (SMD -0.20, 95% CI -0.59 TO 0.19; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.90, 95% -2.61 TO 0.81), AND NO INFORMATION ON BACK-RELATED FUNCTION AFTER SIX MONTHS. THERE WAS VERY LOW-CERTAINTY EVIDENCE FOR LOWER PAIN ON A 0-100 SCALE AT SEVEN MONTHS (MD -20.40, 95% CI -25.48 TO -15.32), AND NO INFORMATION ON PAIN AT THREE MONTHS OR AFTER SEVEN MONTHS. BASED ON INFORMATION FROM THREE TRIALS, THERE WAS LOW-CERTAINTY EVIDENCE FOR NO DIFFERENCE IN THE RISK OF ADVERSE EVENTS BETWEEN YOGA AND NON-YOGA EXERCISE CONTROLS (RD 1%, 95% CI -4% TO 6%).FOR YOGA ADDED TO EXERCISE COMPARED TO EXERCISE ALONE (1 TRIAL; 24 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE AT 10 WEEKS IN BACK-RELATED FUNCTION (SMD -0.60, 95% CI -1.42 TO 0.22; CORRESPONDING TO A CHANGE IN THE OSWESTRY DISABILITY INDEX OF MD -17.05, 95% -22.96 TO 11.14) OR PAIN ON A 0-100 SCALE (MD -3.20, 95% CI -13.76 TO 7.36). THERE WAS NO INFORMATION ON OUTCOMES AT OTHER TIME POINTS. THERE WAS NO INFORMATION ON ADVERSE EVENTS.STUDIES PROVIDED LIMITED EVIDENCE ON RISK OF CLINICAL IMPROVEMENT, MEASURES OF QUALITY OF LIFE, AND DEPRESSION. THERE WAS NO EVIDENCE ON WORK-RELATED DISABILITY. AUTHORS' CONCLUSIONS: THERE IS LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA COMPARED TO NON-EXERCISE CONTROLS RESULTS IN SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE AND SIX MONTHS. YOGA MAY ALSO BE SLIGHTLY MORE EFFECTIVE FOR PAIN AT THREE AND SIX MONTHS, HOWEVER THE EFFECT SIZE DID NOT MEET PREDEFINED LEVELS OF MINIMUM CLINICAL IMPORTANCE. IT IS UNCERTAIN WHETHER THERE IS ANY DIFFERENCE BETWEEN YOGA AND OTHER EXERCISE FOR BACK-RELATED FUNCTION OR PAIN, OR WHETHER YOGA ADDED TO EXERCISE IS MORE EFFECTIVE THAN EXERCISE ALONE. YOGA IS ASSOCIATED WITH MORE ADVERSE EVENTS THAN NON-EXERCISE CONTROLS, BUT MAY HAVE THE SAME RISK OF ADVERSE EVENTS AS OTHER BACK-FOCUSED EXERCISE. YOGA IS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. THERE IS A NEED FOR ADDITIONAL HIGH-QUALITY RESEARCH TO IMPROVE CONFIDENCE IN ESTIMATES OF EFFECT, TO EVALUATE LONG-TERM OUTCOMES, AND TO PROVIDE ADDITIONAL INFORMATION ON COMPARISONS BETWEEN YOGA AND OTHER EXERCISE FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. 2017 13 2820 47 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN (2017). WIELAND LS, SKOETZ N, PILKINGTON K, VEMPATI R, DADAMO CR, BERMAN BM. YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN.COCHRANE DATABASE SYST REV2017, ISSUE 1. ART. NO.: CD010671. DOI: 10.1002/14651858.CD010671.PUB2. BACKGROUND: NON-SPECIFIC LOW BACK PAIN IS A COMMON, POTENTIALLY DISABLING CONDITION USUALLY TREATED WITH SELF-CARE AND NON-PRESCRIPTION MEDICATION. FOR CHRONIC LOW BACK PAIN, CURRENT GUIDELINES STATE THAT EXERCISE THERAPY MAY BE BENEFICIAL. YOGA IS A MIND-BODY EXERCISE SOMETIMES USED FOR NON-SPECIFIC LOW BACK PAIN. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING CHRONIC NON-SPECIFIC LOW BACK PAIN, COMPARED TO NO SPECIFIC TREATMENT, A MINIMAL INTERVENTION (E.G., EDUCATION), OR ANOTHER ACTIVE TREATMENT, WITH A FOCUS ON PAIN, FUNCTION, AND ADVERSE EVENTS. SEARCH METHODS: WE SEARCHED CENTRAL, MEDLINE, EMBASE, FIVE OTHER DATABASES, AND FOUR TRIALS REGISTERS TO 11 MARCH 2016 WITHOUT RESTRICTION OF LANGUAGE OR PUBLICATION STATUS. WE SCREENED REFERENCE LISTS AND CONTACTED EXPERTS IN THE FIELD TO IDENTIFY ADDITIONAL STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMIZED CONTROLLED TRIALS OF YOGA TREATMENT IN PEOPLE WITH CHRONIC NON-SPECIFIC LOW BACK PAIN. WE INCLUDED STUDIES COMPARING YOGA TO ANY OTHER INTERVENTION OR TO NO INTERVENTION. WE ALSO INCLUDED STUDIES COMPARING YOGA AS AN ADJUNCT TO OTHER THERAPIES, VERSUS THOSE OTHER THERAPIES ALONE. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SCREENED AND SELECTED STUDIES, EXTRACTED OUTCOME DATA, AND ASSESSED RISK OF BIAS. WE CONTACTED STUDY AUTHORS TO OBTAIN MISSING OR UNCLEAR INFORMATION. WE EVALUATED THE OVERALL CERTAINTY OF EVIDENCE USING THE GRADE APPROACH. MAIN RESULTS: WE INCLUDED 12 TRIALS (1080 PARTICIPANTS) CARRIED OUT IN THE USA (SEVEN TRIALS), INDIA (THREE TRIALS), AND THE UK (TWO TRIALS). STUDIES WERE UNFUNDED (ONE TRIAL), FUNDED BY A YOGA INSTITUTION (ONE TRIAL), FUNDED BY NON-PROFIT OR GOVERNMENT SOURCES (SEVEN TRIALS), OR DID NOT REPORT ON FUNDING (THREE TRIALS). MOST TRIALS USED IYENGAR, HATHA, OR VINIYOGA FORMS OF YOGA. THE TRIALS COMPARED YOGA TO NO INTERVENTION OR A NON-EXERCISE INTERVENTION SUCH AS EDUCATION (SEVEN TRIALS), AN EXERCISE INTERVENTION (THREE TRIALS), OR BOTH EXERCISE AND NON-EXERCISE INTERVENTIONS (TWO TRIALS). ALL TRIALS WERE AT HIGH RISK OF PERFORMANCE AND DETECTION BIAS BECAUSE PARTICIPANTS AND PROVIDERS WERE NOT BLINDED TO TREATMENT ASSIGNMENT, AND OUTCOMES WERE SELF-ASSESSED. THEREFORE, WE DOWNGRADED ALL OUTCOMES TO "MODERATE" CERTAINTY EVIDENCE BECAUSE OF RISK OF BIAS, AND WHEN THERE WAS ADDITIONAL SERIOUS RISK OF BIAS, UNEXPLAINED HETEROGENEITY BETWEEN STUDIES, OR THE ANALYSES WERE IMPRECISE, WE DOWNGRADED THE CERTAINTY OF THE EVIDENCE FURTHER. FOR YOGA COMPARED TO NON-EXERCISE CONTROLS (9 TRIALS; 810 PARTICIPANTS), THERE WAS LOW-CERTAINTY EVIDENCE THAT YOGA PRODUCED SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE TO FOUR MONTHS [STANDARDIZED MEAN DIFFERENCE (SMD) = -0.40, 95% CI: -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) = -2.18, 95% CI: -3.60 TO -0.76], MODERATE-CERTAINTY EVIDENCE FOR SMALL TO MODERATE IMPROVEMENTS AT SIX MONTHS (SMD = -0.44, 95% CI: -0.66 TO -0.22; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -2.15, 95% CI: -3.23 TO -1.08), AND LOW-CERTAINTY EVIDENCE FOR SMALL IMPROVEMENTS AT 12 MONTHS (SMD = -0.26, 95% CI: -0.46 TO -0.05; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -1.36, 95% CI: -2.41 TO -0.26). ON A 0-100 SCALE THERE WAS VERY LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA WAS SLIGHTLY BETTER FOR PAIN AT THREE TO FOUR MONTHS (MD = -4.55, 95% CI: -7.04 TO -2.06), SIX MONTHS (MD = -7.81, 95% CI: -13.37 TO -2.25), AND 12 MONTHS (MD = -5.40, 95% CI: -14.50 TO -3.70); HOWEVER, WE PRE-DEFINED CLINICALLY SIGNIFICANT CHANGES IN PAIN AS 15 POINTS OR GREATER AND THIS THRESHOLD WAS NOT MET. BASED ON INFORMATION FROM SIX TRIALS, THERE WAS MODERATE-CERTAINTY EVIDENCE THAT THE RISK OF ADVERSE EVENTS, PRIMARILY INCREASED BACK PAIN, WAS HIGHER IN YOGA THAN IN NON-EXERCISE CONTROLS [RISK DIFFERENCE (RD) = 5%, 95% CI: 2-8%]. FOR YOGA COMPARED TO NON-YOGA EXERCISE CONTROLS (4 TRIALS; 394 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE IN BACK-RELATED FUNCTION AT THREE MONTHS (SMD = -0.22, 95% CI: -0.65 TO 0.20; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -0.99, 95% CI: -2.87 TO 0.90) AND SIX MONTHS (SMD = -0.20, 95% CI: -0.59 TO 0.19; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -0.90, 95% CI: -2.61 TO 0.81), AND NO INFORMATION ON BACK-RELATED FUNCTION AFTER SIX MONTHS. THERE WAS VERY LOW-CERTAINTY EVIDENCE FOR LOWER PAIN ON A 0-100 SCALE AT SEVEN MONTHS (MD = -20.40, 95% CI: -25.48 TO -15.32), AND NO INFORMATION ON PAIN AT THREE MONTHS OR AFTER SEVEN MONTHS. BASED ON INFORMATION FROM THREE TRIALS, THERE WAS LOW-CERTAINTY EVIDENCE FOR NO DIFFERENCE IN THE RISK OF ADVERSE EVENTS BETWEEN YOGA AND NON-YOGA EXERCISE CONTROLS (RD = 1%, 95% CI: -4% TO 6%). FOR YOGA ADDED TO EXERCISE COMPARED TO EXERCISE ALONE (1 TRIAL; 24 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE AT 10 WEEKS IN BACK-RELATED FUNCTION (SMD = -0.60, 95% CI: -1.42 TO 0.22; CORRESPONDING TO A CHANGE IN THE OSWESTRY DISABILITY INDEX OF MD = -17.05, 95% CI: -22.96 TO 11.14) OR PAIN ON A 0-100 SCALE (MD = -3.20, 95% CI: -13.76 TO 7.36). THERE WAS NO INFORMATION ON OUTCOMES AT OTHER TIME POINTS. THERE WAS NO INFORMATION ON ADVERSE EVENTS. STUDIES PROVIDED LIMITED EVIDENCE ON RISK OF CLINICAL IMPROVEMENT, MEASURES OF QUALITY OF LIFE, AND DEPRESSION. THERE WAS NO EVIDENCE ON WORK-RELATED DISABILITY. 2017 14 1465 31 INJURIES AND OTHER ADVERSE EVENTS ASSOCIATED WITH YOGA PRACTICE: A SYSTEMATIC REVIEW OF EPIDEMIOLOGICAL STUDIES. OBJECTIVES: TO SYSTEMATICALLY ASSESS THE PREVALENCE OF YOGA-ASSOCIATED INJURIES AND OTHER ADVERSE EVENTS IN EPIDEMIOLOGICAL STUDIES. DESIGN: SYSTEMATIC REVIEW OF OBSERVATIONAL STUDIES. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, AND INDMED WERE SEARCHED THROUGH OCTOBER 2016 FOR EPIDEMIOLOGICAL STUDIES ASSESSING THE PREVALENCE OF ADVERSE EVENTS OF YOGA PRACTICE OR COMPARING THE RISK OF ANY ADVERSE EVENTS BETWEEN YOGA PRACTITIONERS AND NON-YOGA PRACTITIONERS. RESULTS: NINE OBSERVATIONAL STUDIES WITH A TOTAL 9129 YOGA PRACTITIONERS AND 9903 NON-YOGA PRACTITIONERS WERE INCLUDED. INCIDENCE PROPORTION OF ADVERSE EVENTS DURING A YOGA CLASS WAS 22.7% (95% CONFIDENCE INTERVAL [CI]=21.1%-24.3%); 12-MONTHS PREVALENCE WAS 4.6% (95%CI=3.8%-5.4%), AND LIFETIME PREVALENCE RANGED FROM 21.3% (95%CI=19.7%-22.9%) TO 61.8% (95%CI=52.8%-70.8%) OF YOGA PRACTITIONERS. SERIOUS ADVERSE EVENTS OCCURRED IN 1.9% (95%CI=1.4%-2.4%). THE MOST COMMON ADVERSE EVENTS RELATED TO THE MUSCULOSKELETAL SYSTEM; THE MOST COMMON INJURIES WERE SPRAINS AND STRAINS. COMPARED TO NON-YOGA PRACTITIONERS, YOGA PRACTITIONERS HAD A COMPARABLE RISK OF FALLS (ODDS RATIO [OR]=0.90; 95%CI=0.76-1.08), AND FALLS-RELATED INJURIES (OR=1.04; 95%CI=0.83-1.29), AND HIGHER RISK OF MENISCUS INJURIES (OR=1.72; 95%CI=1.23-2.41). CONCLUSIONS: A CONSIDERABLE PROPORTION OF YOGA PRACTITIONERS EXPERIENCED INJURIES OR OTHER ADVERSE EVENTS; HOWEVER MOST WERE MILD AND TRANSIENT AND RISKS WERE COMPARABLE TO THOSE OF NON-YOGA PRACTITIONERS. THERE IS NO NEED TO DISCOURAGE YOGA PRACTICE FOR HEALTHY PEOPLE. PEOPLE WITH SERIOUS ACUTE OR CHRONIC ILLNESSES SHOULD SEEK MEDICAL ADVICE BEFORE PRACTICING YOGA. 2018 15 2543 53 YOGA FOR ASTHMA. BACKGROUND: ASTHMA IS A COMMON CHRONIC INFLAMMATORY DISORDER AFFECTING ABOUT 300 MILLION PEOPLE WORLDWIDE. AS A HOLISTIC THERAPY, YOGA HAS THE POTENTIAL TO RELIEVE BOTH THE PHYSICAL AND PSYCHOLOGICAL SUFFERING OF PEOPLE WITH ASTHMA, AND ITS POPULARITY HAS EXPANDED GLOBALLY. A NUMBER OF CLINICAL TRIALS HAVE BEEN CARRIED OUT TO EVALUATE THE EFFECTS OF YOGA PRACTICE, WITH INCONSISTENT RESULTS. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA IN PEOPLE WITH ASTHMA. SEARCH METHODS: WE SYSTEMATICALLY SEARCHED THE COCHRANE AIRWAYS GROUP REGISTER OF TRIALS, WHICH IS DERIVED FROM SYSTEMATIC SEARCHES OF BIBLIOGRAPHIC DATABASES INCLUDING THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, AND PSYCINFO, AND HANDSEARCHING OF RESPIRATORY JOURNALS AND MEETING ABSTRACTS. WE ALSO SEARCHED PEDRO. WE SEARCHED CLINICALTRIALS.GOV AND THE WHO ICTRP SEARCH PORTAL. WE SEARCHED ALL DATABASES FROM THEIR INCEPTION TO 22 JULY 2015, AND USED NO RESTRICTION ON LANGUAGE OF PUBLICATION. WE CHECKED THE REFERENCE LISTS OF ELIGIBLE STUDIES AND RELEVANT REVIEW ARTICLES FOR ADDITIONAL STUDIES. WE ATTEMPTED TO CONTACT INVESTIGATORS OF ELIGIBLE STUDIES AND EXPERTS IN THE FIELD TO LEARN OF OTHER PUBLISHED AND UNPUBLISHED STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMISED CONTROLLED TRIALS (RCTS) THAT COMPARED YOGA WITH USUAL CARE (OR NO INTERVENTION) OR SHAM INTERVENTION IN PEOPLE WITH ASTHMA AND REPORTED AT LEAST ONE OF THE FOLLOWING OUTCOMES: QUALITY OF LIFE, ASTHMA SYMPTOM SCORE, ASTHMA CONTROL, LUNG FUNCTION MEASURES, ASTHMA MEDICATION USAGE, AND ADVERSE EVENTS. DATA COLLECTION AND ANALYSIS: WE EXTRACTED BIBLIOGRAPHIC INFORMATION, CHARACTERISTICS OF PARTICIPANTS, CHARACTERISTICS OF INTERVENTIONS AND CONTROLS, CHARACTERISTICS OF METHODOLOGY, AND RESULTS FOR THE OUTCOMES OF OUR INTEREST FROM ELIGIBLE STUDIES. FOR CONTINUOUS OUTCOMES, WE USED MEAN DIFFERENCE (MD) WITH 95% CONFIDENCE INTERVAL (CI) TO DENOTE THE TREATMENT EFFECTS, IF THE OUTCOMES WERE MEASURED BY THE SAME SCALE ACROSS STUDIES. ALTERNATIVELY, IF THE OUTCOMES WERE MEASURED BY DIFFERENT SCALES ACROSS STUDIES, WE USED STANDARDISED MEAN DIFFERENCE (SMD) WITH 95% CI. FOR DICHOTOMOUS OUTCOMES, WE USED RISK RATIO (RR) WITH 95% CI TO MEASURE THE TREATMENT EFFECTS. WE PERFORMED META-ANALYSIS WITH REVIEW MANAGER 5.3. WE USED THE FIXED-EFFECT MODEL TO POOL THE DATA, UNLESS THERE WAS SUBSTANTIAL HETEROGENEITY AMONG STUDIES, IN WHICH CASE WE USED THE RANDOM-EFFECTS MODEL INSTEAD. FOR OUTCOMES INAPPROPRIATE OR IMPOSSIBLE TO POOL QUANTITATIVELY, WE CONDUCTED A DESCRIPTIVE ANALYSIS AND SUMMARISED THE FINDINGS NARRATIVELY. MAIN RESULTS: WE INCLUDED 15 RCTS WITH A TOTAL OF 1048 PARTICIPANTS. MOST OF THE TRIALS WERE CONDUCTED IN INDIA, FOLLOWED BY EUROPE AND THE UNITED STATES. THE MAJORITY OF PARTICIPANTS WERE ADULTS OF BOTH SEXES WITH MILD TO MODERATE ASTHMA FOR SIX MONTHS TO MORE THAN 23 YEARS. FIVE STUDIES INCLUDED YOGA BREATHING ALONE, WHILE THE OTHER STUDIES ASSESSED YOGA INTERVENTIONS THAT INCLUDED BREATHING, POSTURE, AND MEDITATION. INTERVENTIONS LASTED FROM TWO WEEKS TO 54 MONTHS, FOR NO MORE THAN SIX MONTHS IN THE MAJORITY OF STUDIES. THE RISK OF BIAS WAS LOW ACROSS ALL DOMAINS IN ONE STUDY AND UNCLEAR OR HIGH IN AT LEAST ONE DOMAIN FOR THE REMAINDER.THERE WAS SOME EVIDENCE THAT YOGA MAY IMPROVE QUALITY OF LIFE (MD IN ASTHMA QUALITY OF LIFE QUESTIONNAIRE (AQLQ) SCORE PER ITEM 0.57 UNITS ON A 7-POINT SCALE, 95% CI 0.37 TO 0.77; 5 STUDIES; 375 PARTICIPANTS), IMPROVE SYMPTOMS (SMD 0.37, 95% CI 0.09 TO 0.65; 3 STUDIES; 243 PARTICIPANTS), AND REDUCE MEDICATION USAGE (RR 5.35, 95% CI 1.29 TO 22.11; 2 STUDIES) IN PEOPLE WITH ASTHMA. THE MD FOR AQLQ SCORE EXCEEDED THE MINIMAL CLINICALLY IMPORTANT DIFFERENCE (MCID) OF 0.5, BUT WHETHER THE MEAN CHANGES EXCEEDED THE MCID FOR ASTHMA SYMPTOMS IS UNCERTAIN DUE TO THE LACK OF AN ESTABLISHED MCID IN THE SEVERITY SCORES USED IN THE INCLUDED STUDIES. THE EFFECTS OF YOGA ON CHANGE FROM BASELINE FORCED EXPIRATORY VOLUME IN ONE SECOND (MD 0.04 LITRES, 95% CI -0.10 TO 0.19; 7 STUDIES; 340 PARTICIPANTS; I(2) = 68%) WERE NOT STATISTICALLY SIGNIFICANT. TWO STUDIES INDICATED IMPROVED ASTHMA CONTROL, BUT DUE TO VERY SIGNIFICANT HETEROGENEITY (I(2) = 98%) WE DID NOT POOL DATA. NO SERIOUS ADVERSE EVENTS ASSOCIATED WITH YOGA WERE REPORTED, BUT THE DATA ON THIS OUTCOME WAS LIMITED. AUTHORS' CONCLUSIONS: WE FOUND MODERATE-QUALITY EVIDENCE THAT YOGA PROBABLY LEADS TO SMALL IMPROVEMENTS IN QUALITY OF LIFE AND SYMPTOMS IN PEOPLE WITH ASTHMA. THERE IS MORE UNCERTAINTY ABOUT POTENTIAL ADVERSE EFFECTS OF YOGA AND ITS IMPACT ON LUNG FUNCTION AND MEDICATION USAGE. RCTS WITH A LARGE SAMPLE SIZE AND HIGH METHODOLOGICAL AND REPORTING QUALITY ARE NEEDED TO CONFIRM THE EFFECTS OF YOGA FOR ASTHMA. 2016 16 467 34 CHARACTERISTICS OF RANDOMIZED CONTROLLED TRIALS OF YOGA: A BIBLIOMETRIC ANALYSIS. BACKGROUND: A GROWING NUMBER OF RANDOMIZED CONTROLLED TRIALS (RCTS) HAVE INVESTIGATED THE THERAPEUTIC VALUE OF YOGA INTERVENTIONS. THIS BIBLIOMETRIC ANALYSIS AIMED TO PROVIDE A COMPREHENSIVE REVIEW OF THE CHARACTERISTICS OF THE TOTALITY OF AVAILABLE RANDOMIZED YOGA TRIALS. METHODS: ALL RCTS OF YOGA WERE ELIGIBLE. MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, INDMED, AND THE TABLES OF CONTENT OF YOGA SPECIALTY JOURNALS NOT LISTED IN MEDICAL DATABASES WERE SCREENED THROUGH FEBRUARY 2014. BIBLIOMETRIC DATA, DATA ON PARTICIPANTS, AND INTERVENTION WERE EXTRACTED AND ANALYZED DESCRIPTIVELY. RESULTS: PUBLISHED BETWEEN 1975 AND 2014, A TOTAL OF 366 PAPERS WERE INCLUDED, REPORTING 312 RCTS FROM 23 DIFFERENT COUNTRIES WITH 22,548 PARTICIPANTS. THE MEDIAN STUDY SAMPLE SIZE WAS 59 (RANGE 8-410, INTERQUARTILE RANGE = 31, 93). TWO HUNDRED SIXTY-FOUR RCTS (84.6%) WERE CONDUCTED WITH ADULTS, 105 (33.7%) WITH OLDER ADULTS AND 31 (9.9%) WITH CHILDREN. EIGHTY-FOUR RCTS (26.9%) WERE CONDUCTED WITH HEALTHY PARTICIPANTS. OTHER TRIALS ENROLLED PATIENTS WITH ONE OF 63 VARIED MEDICAL CONDITIONS; THE MOST COMMON BEING BREAST CANCER (17 RCTS, 5.4%), DEPRESSION (14 RCTS, 4.5%), ASTHMA (14 RCTS, 4.5%) AND TYPE 2 DIABETES MELLITUS (13 RCTS, 4.2%). WHILST 119 RCTS (38.1%) DID NOT DEFINE THE STYLE OF YOGA USED, 35 RCTS (11.2%) USED HATHA YOGA AND 30 RCTS (9.6%) YOGA BREATHING. THE REMAINING 128 RCTS (41.0%) USED 46 VARIED YOGA STYLES, WITH A MEDIAN INTERVENTION LENGTH OF 9 WEEKS (RANGE 1 DAY TO 1 YEAR; INTERQUARTILE RANGE = 5, 12). TWO HUNDRED AND FORTY-FOUR RCTS (78.2%) USED YOGA POSTURES, 232 RCTS (74.4%) USED BREATH CONTROL, 153 RCTS (49.0%) USED MEDITATION AND 32 RCTS (10.3%) USED PHILOSOPHY LECTURES. ONE HUNDRED AND SEVENTY-FOUR RCTS (55.6%) COMPARED YOGA WITH NO SPECIFIC TREATMENT; 21 VARIED CONTROL INTERVENTIONS WERE USED IN THE REMAINING RCTS. CONCLUSIONS: THIS BIBLIOMETRIC ANALYSIS PRESENTS THE MOST COMPLETE UP-TO-DATE OVERVIEW ON PUBLISHED RANDOMIZED YOGA TRIALS. WHILE THE AVAILABLE RESEARCH EVIDENCE IS SPARSE FOR MOST CONDITIONS, THERE WAS A MARKED INCREASE IN PUBLISHED RCTS IN RECENT YEARS. 2014 17 1486 29 INTEGRATIVE EFFECT OF YOGA PRACTICE IN PATIENTS WITH KNEE ARTHRITIS: A PRISMA-COMPLIANT META-ANALYSIS. BACKGROUND: BENEFITS OF YOGA PRACTICE IN PATIENTS WITH KNEE OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS REMAINS CONTROVERSIAL. THIS STUDY PERFORMS A META-ANALYSIS TO QUANTIFY THE EFFICIENCY OF YOGA EXERCISE FOR PATIENTS PAIN REDUCTION, FUNCTIONAL RECOVERY, AND GENERAL WELLBEING. METHODS: A COMPUTERIZED SEARCH OF PUBMED AND EMBASE WAS PERFORMED TO IDENTIFY RELEVANT STUDIES. THE OUTCOME MEASURES WERE PAIN, STIFFNESS, AND PHYSICAL FUNCTION. TWO INVESTIGATORS IDENTIFIED ELIGIBLE STUDIES AND EXTRACTED DATA INDEPENDENTLY. THE QUALITY OF CITATIONS WAS MEASURED USING JADAD SCORE. STANDARDIZED MEAN DIFFERENCES (SMDS) WITH 95% CONFIDENCE INTERVALS (CIS) WERE CALCULATED FOR PAIN, MUSCULOSKELETAL IMPAIRMENT, QUALITY OF LIFE, GENERAL WELLBEING, AND MENTAL WELLBEING. RESULTS: A TOTAL OF 13 CLINICAL TRIALS INVOLVING 1557 PATIENTS WITH KNEE OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS WERE INCLUDED IN FINAL META-ANALYSIS WITH THE AVERAGE JADAD SCORE 2.8. THE SMD WAS -0.98 (95% CI -1.18, -0.78, P < .05) FOR PAIN, -1.83 (95% CI -2.09, -1.57, P < .05) FOR FUNCTIONAL DISABILITY, WAS 0.80 (95% CI 0.59, 1.01, P < .05) FOR SHORT FORM 36 HEALTH SURVEY (SF-36) GENERAL HEALTH, 0.49 (95% CI 0.14, 0.82, P < .05) FOR SF-36 MENTAL HEALTH, AND HAQ WAS -0.55 (95% CI -0.83, -0.26, P < .05) FOR HEALTH ASSOCIATED QUESTIONNAIRE (HAQ). ALL THE RESULTS FAVOR YOGA TRAINING GROUP. CONCLUSIONS: REGULAR YOGA TRAINING IS HELPFUL IN REDUCING KNEE ARTHRITIC SYMPTOMS, PROMOTING PHYSICAL FUNCTION, AND GENERAL WELLBEING IN ARTHRITIC PATIENTS. 2018 18 2636 45 YOGA FOR TREATING URINARY INCONTINENCE IN WOMEN. BACKGROUND: URINARY INCONTINENCE IN WOMEN IS ASSOCIATED WITH POOR QUALITY OF LIFE AND DIFFICULTIES IN SOCIAL, PSYCHOLOGICAL AND SEXUAL FUNCTIONING. THE CONDITION MAY AFFECT UP TO 15% OF MIDDLE-AGED OR OLDER WOMEN IN THE GENERAL POPULATION. CONSERVATIVE TREATMENTS SUCH AS LIFESTYLE INTERVENTIONS, BLADDER TRAINING AND PELVIC FLOOR MUSCLE TRAINING (USED EITHER ALONE OR IN COMBINATION WITH OTHER INTERVENTIONS) ARE THE INITIAL APPROACHES TO THE MANAGEMENT OF URINARY INCONTINENCE. MANY WOMEN ARE INTERESTED IN ADDITIONAL TREATMENTS SUCH AS YOGA, A SYSTEM OF PHILOSOPHY, LIFESTYLE AND PHYSICAL PRACTICE THAT ORIGINATED IN ANCIENT INDIA. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING URINARY INCONTINENCE IN WOMEN. SEARCH METHODS: WE SEARCHED THE COCHRANE INCONTINENCE AND COCHRANE COMPLEMENTARY MEDICINE SPECIALISED REGISTERS. WE SEARCHED THE WORLD HEALTH ORGANIZATION INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (WHO ICTRP) AND CLINICALTRIALS.GOV TO IDENTIFY ANY ONGOING OR UNPUBLISHED STUDIES. WE HANDSEARCHED PROCEEDINGS OF THE INTERNATIONAL CONGRESS ON COMPLEMENTARY MEDICINE RESEARCH AND THE EUROPEAN CONGRESS FOR INTEGRATIVE MEDICINE. WE SEARCHED THE NHS ECONOMIC EVALUATION DATABASE FOR ECONOMIC STUDIES, AND SUPPLEMENTED THIS SEARCH WITH SEARCHES FOR ECONOMICS STUDIES IN MEDLINE AND EMBASE FROM 2015 ONWARDS. DATABASE SEARCHES ARE UP-TO-DATE AS OF 21 JUNE 2018. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS IN WOMEN DIAGNOSED WITH URINARY INCONTINENCE IN WHICH ONE GROUP WAS ALLOCATED TO TREATMENT WITH YOGA. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY SCREENED TITLES AND ABSTRACTS OF ALL RETRIEVED ARTICLES, SELECTED STUDIES FOR INCLUSION, EXTRACTED DATA, ASSESSED RISK OF BIAS AND EVALUATED THE CERTAINTY OF THE EVIDENCE FOR EACH REPORTED OUTCOME. ANY DISAGREEMENTS WERE RESOLVED BY CONSENSUS. WE PLANNED TO COMBINE CLINICALLY COMPARABLE STUDIES IN REVIEW MANAGER 5 USING RANDOM-EFFECTS META-ANALYSIS AND TO CARRY OUT SENSITIVITY AND SUBGROUP ANALYSES. WE PLANNED TO CREATE A TABLE LISTING ECONOMIC STUDIES ON YOGA FOR INCONTINENCE BUT NOT CARRY OUT ANY ANALYSES ON THESE STUDIES. MAIN RESULTS: WE INCLUDED TWO STUDIES (INVOLVING A TOTAL OF 49 WOMEN). EACH STUDY COMPARED YOGA TO A DIFFERENT COMPARATOR, THEREFORE WE WERE UNABLE TO COMBINE THE DATA IN A META-ANALYSIS. A THIRD STUDY THAT HAS BEEN COMPLETED BUT NOT YET FULLY REPORTED IS AWAITING ASSESSMENT.ONE INCLUDED STUDY WAS A SIX-WEEK STUDY COMPARING YOGA TO A WAITING LIST IN 19 WOMEN WITH EITHER URGENCY URINARY INCONTINENCE OR STRESS URINARY INCONTINENCE. WE JUDGED THE CERTAINTY OF THE EVIDENCE FOR ALL REPORTED OUTCOMES AS VERY LOW DUE TO PERFORMANCE BIAS, DETECTION BIAS, AND IMPRECISION. THE NUMBER OF WOMEN REPORTING CURE WAS NOT REPORTED. WE ARE UNCERTAIN WHETHER YOGA RESULTS IN SATISFACTION WITH CURE OR IMPROVEMENT OF INCONTINENCE (RISK RATIO (RR) 6.33, 95% CONFIDENCE INTERVAL (CI) 1.44 TO 27.88; AN INCREASE OF 592 FROM 111 PER 1000, 95% CI 160 TO 1000). WE ARE UNCERTAIN WHETHER THERE IS A DIFFERENCE BETWEEN YOGA AND WAITING LIST IN CONDITION-SPECIFIC QUALITY OF LIFE AS MEASURED ON THE INCONTINENCE IMPACT QUESTIONNAIRE SHORT FORM (MEAN DIFFERENCE (MD) 1.74, 95% CI -33.02 TO 36.50); THE NUMBER OF MICTURITIONS (MD -0.77, 95% CI -2.13 TO 0.59); THE NUMBER OF INCONTINENCE EPISODES (MD -1.57, 95% CI -2.83 TO -0.31); OR THE BOTHERSOMENESS OF INCONTINENCE AS MEASURED ON THE UROGENITAL DISTRESS INVENTORY 6 (MD -0.90, 95% CI -1.46 TO -0.34). THERE WAS NO EVIDENCE OF A DIFFERENCE IN THE NUMBER OF WOMEN WHO EXPERIENCED AT LEAST ONE ADVERSE EVENT (RISK DIFFERENCE 0%, 95% CI -38% TO 38%; NO DIFFERENCE FROM 222 PER 1000, 95% CI 380 FEWER TO 380 MORE).THE SECOND INCLUDED STUDY WAS AN EIGHT-WEEK STUDY IN 30 WOMEN WITH URGENCY URINARY INCONTINENCE THAT COMPARED MINDFULNESS-BASED STRESS REDUCTION (MBSR) TO AN ACTIVE CONTROL INTERVENTION OF YOGA CLASSES. THE STUDY WAS UNBLINDED, AND THERE WAS HIGH ATTRITION FROM BOTH STUDY ARMS FOR ALL OUTCOME ASSESSMENTS. WE JUDGED THE CERTAINTY OF THE EVIDENCE FOR ALL REPORTED OUTCOMES AS VERY LOW DUE TO PERFORMANCE BIAS, ATTRITION BIAS, IMPRECISION AND INDIRECTNESS. THE NUMBER OF WOMEN REPORTING CURE WAS NOT REPORTED. WE ARE UNCERTAIN WHETHER WOMEN IN THE YOGA GROUP WERE LESS LIKELY TO REPORT IMPROVEMENT IN INCONTINENCE AT EIGHT WEEKS COMPARED TO WOMEN IN THE MBSR GROUP (RR 0.09, 95% CI 0.01 TO 1.43; A DECREASE OF 419 FROM 461 PER 1000, 95% CI 5 TO 660). WE ARE UNCERTAIN ABOUT THE EFFECT OF MBSR COMPARED TO YOGA ON REPORTS OF CURE OR IMPROVEMENT IN INCONTINENCE, IMPROVEMENT IN CONDITION-SPECIFIC QUALITY OF LIFE MEASURED ON THE OVERACTIVE BLADDER HEALTH-RELATED QUALITY OF LIFE SCALE, REDUCTION IN INCONTINENCE EPISODES OR REDUCTION IN BOTHERSOMENESS OF INCONTINENCE AS MEASURED ON THE OVERACTIVE BLADDER SYMPTOM AND QUALITY OF LIFE-SHORT FORM AT EIGHT WEEKS. THE STUDY DID NOT REPORT ON ADVERSE EFFECTS. AUTHORS' CONCLUSIONS: WE IDENTIFIED FEW TRIALS ON YOGA FOR INCONTINENCE, AND THE EXISTING TRIALS WERE SMALL AND AT HIGH RISK OF BIAS. IN ADDITION, WE DID NOT FIND ANY STUDIES OF ECONOMIC OUTCOMES RELATED TO YOGA FOR URINARY INCONTINENCE. DUE TO THE LACK OF EVIDENCE TO ANSWER THE REVIEW QUESTION, WE ARE UNCERTAIN WHETHER YOGA IS USEFUL FOR WOMEN WITH URINARY INCONTINENCE. ADDITIONAL, WELL-CONDUCTED TRIALS WITH LARGER SAMPLE SIZES ARE NEEDED. 2019 19 1787 39 PREFERENCE AND EXPECTATION FOR TREATMENT ASSIGNMENT IN A RANDOMIZED CONTROLLED TRIAL OF ONCE- VS TWICE-WEEKLY YOGA FOR CHRONIC LOW BACK PAIN. BACKGROUND: IN STUDIES INVOLVING NONPHARMACOLOGICAL COMPLEMENTARY AND ALTERNATIVE MEDICINE INTERVENTIONS, PARTICIPANT BLINDING IS VERY DIFFICULT. PARTICIPANT EXPECTATIONS MAY AFFECT PERCEIVED BENEFIT OF THERAPY. IN STUDIES OF YOGA AS TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE RELATIONSHIP BETWEEN PATIENT EXPECTATIONS AND PREFERENCES ON OUTCOMES. THIS STUDY WAS DESIGNED TO IDENTIFY BASELINE PREDICTORS OF PREFERENCE AND TO DETERMINE IF EXPECTATIONS AND PREFERENCES FOR DIFFERENT DOSES OF YOGA AFFECT BACK-RELATED FUNCTION AND LOW BACK PAIN INTENSITY. METHODS: THIS WAS A SECONDARY DATA ANALYSIS OF A 12-WEEK RANDOMIZED CONTROLLED TRIAL COMPARING ONCE-WEEKLY VS TWICE-WEEKLY YOGA FOR TREATMENT OF CHRONIC LOW BACK PAIN IN 93 ADULTS FROM A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. AT BASELINE, PARTICIPANTS WERE ASKED ABOUT BACK FUNCTION, BACK PAIN, TREATMENT EXPECTATIONS, AND TREATMENT PREFERENCES. WE CREATED A VARIABLE "CONCORDANCE" TO DESCRIBE THE MATCHING OF PARTICIPANT PREFERENCE TO RANDOMIZED TREATMENT. OUR OUTCOME VARIABLES WERE CHANGE IN BACK FUNCTION AND PAIN INTENSITY AFTER 12 WEEKS OF YOGA INSTRUCTION. WE PERFORMED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF PREFERENCE FOR ONCE- OR TWICE-WEEKLY YOGA INSTRUCTION. WE CREATED LINEAR REGRESSION MODELS TO IDENTIFY INDEPENDENT ASSOCIATIONS BETWEEN EXPECTATIONS, PREFERENCE, CONCORDANCE, AND OUTCOMES. RESULTS: WORSE BACK FUNCTION AT BASELINE WAS ASSOCIATED WITH 20% HIGHER ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 1.2, CI 1.1, 1.3). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR TWICE-WEEKLY YOGA HAD 90% HIGHER ODDS OF PREFERRING TWICE-WEEKLY VS ONCE-WEEKLY YOGA (OR 1.9, CI 1.3, 2.7). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR ONCE-WEEKLY YOGA HAD 40% LESS ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 0.6, CI 0.5, 0.9). AFTER CONTROLLING FOR BASELINE CHARACTERISTICS, WE FOUND NO STATISTICALLY SIGNIFICANT RELATIONSHIP BETWEEN TREATMENT OUTCOMES, PREFERENCE, EXPECTATION SCORES, OR CONCORDANCE. CONCLUSION: IN A POPULATION OF PREDOMINANTLY LOW-INCOME MINORITY PARTICIPANTS WITH CHRONIC LOW BACK PAIN, WORSE BACK FUNCTION WAS ASSOCIATED WITH PREFERENCE FOR MORE FREQUENT YOGA CLASSES. THOSE WHO PREFERRED MORE YOGA CLASSES HAD HIGHER EXPECTATIONS FOR THOSE CLASSES. TWELVE-WEEK CHANGE IN BACK PAIN INTENSITY AND BACK FUNCTION WERE NOT AFFECTED BY DOSING PREFERENCE, EXPECTATION SCORE, OR CONCORDANCE. MORE RESEARCH IS NEEDED TO BETTER MEASURE AND QUANTIFY PREFERENCE, EXPECTATIONS, AND THEIR RELATIONSHIP TO OUTCOMES IN YOGA RESEARCH. 2015 20 2518 37 YOGA COMPARED TO NON-EXERCISE OR PHYSICAL THERAPY EXERCISE ON PAIN, DISABILITY, AND QUALITY OF LIFE FOR PATIENTS WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: CHRONIC LOW BACK PAIN (CLBP) IS A COMMON AND OFTEN DISABLING MUSCULOSKELETAL CONDITION. YOGA HAS BEEN PROVEN TO BE AN EFFECTIVE THERAPY FOR CHRONIC LOW BACK PAIN. HOWEVER, THERE ARE STILL CONTROVERSIES ABOUT THE EFFECTS OF YOGA AT DIFFERENT FOLLOW-UP PERIODS AND COMPARED WITH OTHER PHYSICAL THERAPY EXERCISES. OBJECTIVE: TO CRITICALLY COMPARE THE EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, QUALITY OF LIFE WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION), PHYSICAL THERAPY EXERCISE. METHODS: THIS STUDY WAS REGISTERED IN PROSPERO, AND THE REGISTRATION NUMBER WAS CRD42020159865. RANDOMIZED CONTROLLED TRIALS (RCTS) OF ONLINE DATABASES INCLUDED PUBMED, WEB OF SCIENCE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, EMBASE WHICH EVALUATED EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, AND QUALITY OF LIFE WERE SEARCHED FROM INCEPTION TIME TO NOVEMBER 1, 2019. STUDIES WERE ELIGIBLE IF THEY ASSESSED AT LEAST ONE IMPORTANT OUTCOME, NAMELY PAIN, BACK-SPECIFIC DISABILITY, QUALITY OF LIFE. THE COCHRANE RISK OF BIAS TOOL WAS USED TO ASSESS THE METHODOLOGICAL QUALITY OF INCLUDED RANDOMIZED CONTROLLED TRIALS. THE CONTINUOUS OUTCOMES WERE ANALYZED BY CALCULATING THE MEAN DIFFERENCE (MD) OR STANDARDIZED MEAN DIFFERENCE (SMD) WITH 95% CONFIDENCE INTERVALS (CI) ACCORDING TO WHETHER COMBINING OUTCOMES MEASURED ON DIFFERENT SCALES OR NOT. RESULTS: A TOTAL OF 18 RANDOMIZED CONTROLLED TRIALS WERE INCLUDED IN THIS META-ANALYSIS. YOGA COULD SIGNIFICANTLY REDUCE PAIN AT 4 TO 8 WEEKS (MD = -0.83, 95% CI = -1.19 TO -0.48, P<0.00001, I2 = 0%), 3 MONTHS (MD = -0.43, 95% CI = -0.64 TO -0.23, P<0.0001, I2 = 0%), 6 TO 7 MONTHS (MD = -0.56, 95% CI = -1.02 TO -0.11, P = 0.02, I2 = 50%), AND WAS NOT SIGNIFICANT IN 12 MONTHS (MD = -0.52, 95% CI = -1.64 TO 0.59, P = 0.36, I2 = 87%) COMPARED WITH NON-EXERCISE. YOGA WAS BETTER THAN NON-EXERCISE ON DISABILITY AT 4 TO 8 WEEKS (SMD = -0.30, 95% CI = -0.51 TO -0.10, P = 0.003, I2 = 0%), 3 MONTHS (SMD = -0.31, 95% CI = -0.45 TO -0.18, P<0.00001, I2 = 30%), 6 MONTHS (SMD = -0.38, 95% CI = -0.53 TO -0.23, P<0.00001, I2 = 0%), 12 MONTHS (SMD = -0.33, 95% CI = -0.54 TO -0.12, P = 0.002, I2 = 9%). THERE WAS NO SIGNIFICANT DIFFERENCE ON PAIN, DISABILITY COMPARED WITH PHYSICAL THERAPY EXERCISE GROUP. FURTHERMORE, IT SUGGESTED THAT THERE WAS A NON-SIGNIFICANT DIFFERENCE ON PHYSICAL AND MENTAL QUALITY OF LIFE BETWEEN YOGA AND ANY OTHER INTERVENTIONS. CONCLUSION: THIS META-ANALYSIS PROVIDED EVIDENCE FROM VERY LOW TO MODERATE INVESTIGATING THE EFFECTIVENESS OF YOGA FOR CHRONIC LOW BACK PAIN PATIENTS AT DIFFERENT TIME POINTS. YOGA MIGHT DECREASE PAIN FROM SHORT TERM TO INTERMEDIATE TERM AND IMPROVE FUNCTIONAL DISABILITY STATUS FROM SHORT TERM TO LONG TERM COMPARED WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION). YOGA HAD THE SAME EFFECT ON PAIN AND DISABILITY AS ANY OTHER EXERCISE OR PHYSICAL THERAPY. YOGA MIGHT NOT IMPROVE THE PHYSICAL AND MENTAL QUALITY OF LIFE BASED ON THE RESULT OF A MERGING. 2020